This past Tuesday I took my eldest back to college, her sophomore return far more blasé than had been her long-awaited freshman arrival one year ago, the latter having been made even far more smashing by a goodly portion of the men’s soccer team’s having hustled her every belonging up to her fourth floor room, all in a grand welcome to the joy-filled communal life of Goshen College that was awaiting her.

This year, it was her boyfriend, she and I who trudged about twice as much stuff up the same four floors, with constant reminders from her to keep it moving so that a). she wouldn’t miss her first Ministry Leader’s meeting and b). the fish wouldn’t die. Given the ungodly amount of cash she’d dropped at the pet store mere days earlier to make sure said fish would have a comfy home within which to reside (a fish, I might add, up to that point unnamed, lest such a christening turn out for naught, given the perils of the anticipated three-hour car ride), I easily could understand her new-pet-mom solicitude.

Understand and appreciate, of course, being quite separate activities.

I joyfully report to you, dear Reader, that 1). said fish survived and is now most assuredly named, 2). she and her boyfriend have been reunited, 3). Dad was released to his three-hour car ride back home with a heartfelt, albeit somewhat hastened farewell, and ergo 4). God is in His Heaven.

And I was exhausted. I won’t even begin to tell you the number of patients I had to see the day before and the day after in order to make all this exhaustion possible (joyfully possible, of course).

My patient and I met again the day after The Great Return. It had been almost a week since he and I had sat before that computer screen and watched in external reality that progression of images that daily form his internal one (2K, 1 by 1). His spirits were better, given that we had made some progress in perhaps finding him a place in a residential treatment program. We made plans to see each other again on Friday.

By Friday’s arrival, I had an even better appreciation of the scope of meaning inherent in the mere word exhaustion.

Fortunately, though, my patient always brings a certain reliable, appropriately-restrained “joyful” to my door every time he comes, his smiling “Hello, Doctor!” always reminding me of the young college grad ready to tackle another day of the boss’s to-do list with that can-do attitude that will take this young man far in life, I tell you, far, far.

His is a smile that can make an exhausting day less so. His is also a smile–as he and I both well know–that usually belies a pain underneath that, in just a matter of minutes, both of us will be forced to confront.

We started our time together by my reading him the narrative I had written for his program application. In it I had endeavored to convey both my respect and hope for him, while also my concerns which, like his, are not trivial.

“I guess that about says it, Doc,” he responded, followed by a few seconds of silence and then, “I hope it works.”

I’d be hard-pressed to say that he ever looks vulnerable in the usually understanding of that word. At that moment he was more like cautiously expectant, with the look of someone who really does have something he’d like to say, but who’s not quite sure whether now’s a good time.

“How have you been?” I simply asked.

He shrugged, producing a faint semi-snicker with a faint semi-smile that was, apparently, his body’s forewarning to both of us that–get prepared, boys–now’s the time.

“OK, I guess,” his voice, his gaze already beginning to assume that just-the-other-side-of-Baghdad air that I have come to know so well.

He then began to speak, though not at all a monologue. Instead it was an extended, open invitation to me to bear witness, to sit there, listen, to acknowledge that words were being produced by his vocal chords, that physics was doing its part to transmit sine waves through the atmosphere to my tympanic membranes, all with the hope that, please, I would allow those very sine waves to insinuate themselves into my own neuronal system, my circulating blood, my life.

He had actually suffered two injuries while on deployment. The first, while significant, was managed relatively easily in the advanced medical world of the modern combat theater. He had returned to his buddies as quickly as he could. They needed him. He needed them.

The second was another matter altogether.

Although I had known the basics of what had happened, he went on to tell me, detail after detail, what he remembered, what he had been told, what he surmised. He gave me all that was necessary to visualize the truck, his position in it, the positions of so many others, their duties, their quirks, their unexpected companions . . .

The remains of all the above after the blast.

While I had known that he “really should not be alive,” up to that point, I had not really . . . known.

It is on days such as these that I am glad that I am as old as I am. I would never have been ready for this as a younger man. Honestly, I’m not ready for it now. But at least I do know that silent witness can make all the difference–or more accurately, the silent permission to allow another to implant his pain into my body, my knowing all along that the pain is his, not mine, and that therefore my body need not react as his, but instead react as one who only has an inkling of his pain, but a genuine inkling, not a facsimile of it, but a meaningful portion of the real deal.

He looked directly at me.

“They don’t tell you about this, Doc, in the movies, at the recruiters office. They don’t tell what it’s like to look into the body of another and see . . .”

I have no clue how long the next silence lasted.

“Have you ever seen my picture from afterwards?” he finally asked, sort of with a sardonic levity, I guess you could say.

“The one of you in the hospital?” I responded, remembering seeing somewhere the emaciated body of a young man (that much I could discern), appearing as perplexed and battle-worn as most folks do the minute they’re transferred to the floor from the ICU.

“No, my ID.”

I then remembered something about his having lost his ID in the explosion, about his having to have had another one made in order to get him to his next phase of stabilization in Germany.

“Here,” he said after pulling a piece of plastic out of his wallet, handing it to me. “I still keep it with me.”

I took it.

Do you know what I thought of at that moment, that very first instant I saw that picture that, thankfully, was of a human, but not of one whom I’d ever met, not of one who should have to appear as that human appeared in that photo, that very first instant that stopped the flow of my thoughts, my feelings as if the needle of an old vinyl record player in my head had been savagely ripped across the grooves, bringing silence only after having first embedded a permanent scar of its skid?

His mom and dad.

Even at this very moment, sitting on my porch on a quiet, sunny, Midwestern morning, I hold back, with some effort, the tears as I wonder, in spite of my desperately not wanting to wonder: oh, my God, what if that had been my son?

I can actually begin to feel the beginnings of my blood pooling into my nether regions. I’m actually glad I’m seated. I can’t go there. And I am doing just that, going there, right here, right now.

I suspect I did the same in front of my patient just hours ago. But honestly, I can’t remember.

All I can remember is this: very softly he began to speak, no longer looking in my direction, but rather back toward the other side of the Earth. He was in his own world–and he was in mine. His eloquence was literally–and I do mean that word, literally as in literally–breathtaking. He spoke of his exhaustion, one for which the word dwarfed cannot even begin to describe its comparison to the measly exhaustion I’d been experiencing up to that point. He spoke of his fury, at the politicians who sent him there, even as he spoke of his love for the Nation’s people for whom he had served. And he spoke of the ghosts that haunt him daily, the spirits of those men, some of whom he’d just tolerated, some of whom he’d loved more than life itself, all for whom he would have died in their stead.

And he spoke of the most terrifying ghost of all.

“It’s the ghost of my innocence, Doc,” he said, slowly, as if watching it at that very moment stalking him, having the gall to stand right there in front of him, looking him square in the eye, daring him to say one more word. “I’ll never get it back. But it’s like it won’t leave me. It just follows me. I can’t shake it, Doc.”

After a few moments of silence, he looked right at me, not furious, not confused. Only exhausted.

“I just want it to end, Doc. I want a life again.”

As we gazed at each other for the next few moments, therapy, like Life, took one of its odd turns. When I was training as a child and adolescent psychiatrist in Boston, I learned a very important lesson: sometimes pain can be so overwhelming, its only relief is movement. Literally.

At the very moment I remembered that, he said to me, “I’ve got to have a cigarette, Doc.”

I smiled. “Want to go for a walk?”

Clearly he was surprised, but it took only moments for the yes-sir smile to return. “Sure.”

It was the end of the day. I only had paperwork ahead of me. So together we made our way out to the parking lot, to his car with its Purple Heart license plate. He lit up. We chatted, about the Mennonite church, about my uncle who had died in World War II, about my complex relationship with War and with the men and women who must fight in it, who fight because that is what they have pledged their honor and their lives to do, whether or not any of the rest of us think they should have. We talked about his parents, about his desire that I speak with them about the treatment options he and I are considering. He finished his smoke. We headed back to the office. He grabbed his cap, squared it on his head.

There he was again, the recent college grad bidding adieu to the boss after a well-executed day, the smile the corporal must give the colonel when he’s taking leave to go back to the barracks after finishing his assigned tasks–and quite well, I might add, sir, don’t you agree?

“See you Tuesday, Doc,” he said.

“See you then.”

We shook hands, and he left.

And, yes, those ghosts left with him as well. Yet for a while, they had haunted me that day, too. And I can only hope that after having done so, when they return to this fine young man, so physically reconstructed by science that he goes back now to Mom and Dad looking just ever so slightly older than did that twenty-one year old who took his leave to fly to Kuwait all those years ago, those ghosts will find a way, gently, to remind him that they no longer wish to haunt him, but rather that they wish to solidify into the foundation upon which he can emotionally, spiritually be reconstructed as well, into a future that will be theirs precisely because it will be his.

And I’m quite sure: the ghost of his innocence will gladly join them in that goal.